بررسی اجمالی
مچ درد چیست؟
مچ دست شما مفصلی است که دست و ساعد شما را به هم متصل می کند. مفصل مچ شما شامل بسیاری از استخوان های کوچک است که به شما کمک می کند دست و مچ خود را خم کنید، صاف کنید و بچرخانید. بسیاری از مشکلات قابل درمان می توانند باعث درد، بی حسی یا گزگز در مچ دست و دست شوند.

علل احتمالی
چه چیزی باعث درد مچ دست می شود؟
اگر بعد از زمین خوردن مچ درد دارید، عکسبرداری با اشعه ایکس ممکن است نشان دهد که شما دچار شکستگی، رگ به رگ شدن یا پارگی جزئی رباط هستید، اما گاهی اوقات دردهای مرموز ظاهر می شود. این علائم ممکن است بیایند و بروند، در طول روز بدتر شوند و یا هرگز از بین نخواهند رفت. پیدا کردن علت درد مزمن مچ دست می تواند یک چالش باشد. شما باید به ارائه دهنده مراقبت های بهداشتی خود مراجعه کنید که معاینه دقیقی انجام می دهد و مطالعات تصویربرداری مناسب را انجام می دهد.
ممکن است درد مچ دست داشته باشید به دلیل:
- سندرم تونل کارپال: این مشکل رایج دست باعث درد، بی حسی، گزگز و ضعف در دست و مچ می شود. سندرم تونل کارپال یک پدیده فشار بازه ای است که زمانی رخ می دهد که تورم ناشی از حرکات مکرر یا وزن اضافی، عصب میانی را در کانال خود فشار دهد. این عصب از طریق مچ دست شما حرکت می کند و احساس و حرکت را در دست شما ایجاد می کند.
- تاندونیت: بسیاری از تاندونها از مچ دست عبور میکنند تا حرکت مچ دست و انگشتان را فراهم کنند. اگر آنها تحریک شوند، این تاندونها میتوانند متورم شوند و باعث درد همراه با حرکت یا پارگی شدید خود به خود شوند. تنوسینوویت De Quervain یکی از شایع ترین اشکال تاندونیت است. این در امتداد سمت شست مچ دست شما رخ می دهد. با تنوسینوویت دو کوئروین، زمانی که با شست و مچ دست خود حرکت می کنید، درد شدیدی خواهید داشت. اگر این علائم را تجربه کردید، برای تشخیص دقیق به پزشک مراجعه کنید.
- کیست گانگلیونی: کیست گانگلیونی یک توده غیر سرطانی (خوش خیم) پر از مایع است که روی مفاصل مچ دست و تاندون ها ایجاد می شود. یک کیست بزرگ می تواند به اعصاب مچ دست فشار بیاورد و باعث بی حسی، سوزن سوزن شدن و درد مبهم شود. این وضعیت خطرناک یا مضر نیست، اما می تواند باعث ناراحتی شود.
- نقرس: نوعی آرتریت، نقرس مفاصل را ملتهب می کند و آنها را دردناک، حساس و متورم می کند. مفصل آسیب دیده ممکن است در لمس گرم احساس شود. نقرس زمانی اتفاق می افتد که اسید اوریک بیش از حد (یک ماده زائد حاصل از هضم غذا) در جریان خون شما جمع شود. اسید اضافی باعث ایجاد کریستال های ریز و دردناک در مفاصل و بافت نرم شما می شود.
- استئوآرتریت: این شکل از آرتریت زمانی ایجاد می شود که غضروف، بافت همبند که انتهای استخوان ها را می پوشاند، فرسوده شود. در بیماری استئوآرتریت ، استخوان به استخوان ساییده می شود و باعث درد، تورم و سفتی می شود.
- آرتریت پسوریاتیک: افراد مبتلا به پسوریازیس ، یک اختلال پوستی که باعث ایجاد لکه های پوستی ضخیم و پوسته پوسته می شود، ممکن است به آرتریت پسوریاتیک مبتلا شوند. این آرتریت باعث درد، حساسیت و تورم مچ دست می شود. می تواند منجر به سفتی و کاهش دامنه حرکتی شود.
- آرتریت روماتوئید: آرتریت روماتوئید (RA) یکی دیگر از بیماری های خود ایمنی است که اغلب در مفاصل کوچک دست و مچ شروع می شود. معمولا هر دو دست یا مچ دست را درگیر می کند. افراد مبتلا به آرتریت روماتوئید در مچ دست خود ممکن است درد، تورم و سفتی مفاصل را تجربه کنند.
- لوپوس: لوپوس اریتماتوز سیستمیک یک بیماری خودایمنی است که باعث می شود بدن به بافت سالم خودش حمله کند. افراد مبتلا به لوپوس اغلب در مفاصل کوچک مچ دست و دست خود دچار آرتروز می شوند.
منابع غیرمعمول و نادر درد مچ دست عبارتند از:
- عفونت
- تومور.
- نکروز آواسکولار (از دست دادن خون) استخوان کارپال.
- فشرده سازی عصب گردنی (گردن).
مراقبت و درمان
درد مچ دست چگونه درمان می شود؟
درمان درد مچ دست بسته به علت آن متفاوت است. بسته به شدت، ممکن است برای شکستگی به یک آتل محافظ یا گچ گیری نیاز داشته باشید. اگر شکستگی ناپایدار باشد، ممکن است نیاز به جراحی داشته باشید. استفاده از یک تکیه گاه طولانی مانند گچ، بریس یا آتل می تواند درد ناشی از رگ به رگ شدن، سندرم تونل کارپال یا آرتریت را کاهش دهد. مداخله جراحی حمایت داخلی را فراهم می کند.
برای دردهای مزمن و شدید، پزشک ممکن است توصیه کند:
- داروهای خوراکی و/یا تزریقی برای تسکین علائم.
- جراحی تونل کارپال برای کاهش فشار روی عصب مدیان.
- آزادسازی تاندون های فشرده با جراحی.
- جراحی برای کاهش تماس استخوان روی استخوان ناشی از آرتریت. این می تواند شامل روش های حفظ حرکت مانند همجوشی احتمالی مچ دست، برداشتن استخوان یا تعویض کامل یا جزئی مچ دست باشد.
- برداشتن بافت ملتهب (دبریدمان مچ دست). جراح شما ممکن است از روش باز یا آرتروسکوپی (کم تهاجمی) استفاده کند.
چگونه می توانم درد مچ دست را در خانه درمان کنم؟
ممکن است لازم باشد فعالیت هایی را که درد مچ دست را تشدید می کنند محدود یا متوقف کنید. سایر درمان های خانگی عبارتند از:
- کمپرس سرد برای آسیب های حاد.
- کمپرس گرم برای شرایط مزمن.
- تمرینات دستی که توسط دست درمانگران دارای گواهی کاردرمانی یا فیزیوتراپی هدایت می شوند.
- داروهای ضد التهابی غیر استروئیدی بدون نسخه (NSAIDs)، NSAIDهای موضعی که روی پوست اعمال می شوند (کرم های تسکین دهنده درد).
- داروهای کورتیکواستروئید خوراکی یا تزریقی.
چگونه می توانم از درد مچ دست جلوگیری کنم؟
برخی از حرکات تکراری می تواند باعث درد مچ دست شود یا باعث درد بیشتر آن شود. بسیاری از ما زمان زیادی را صرف تایپ کردن می کنیم. می توانید تنظیمات میز خود را تغییر دهید تا از تحریک مچ دست و تاندون های اطراف آن خلاص شوید. این مراحل می تواند به جلوگیری از درد مچ دست کمک کند:
- صفحه کلید خود را پایین بیاورید تا مچ دستتان هنگام تایپ به سمت بالا خم نشود.
- از تایپ کردن به طور دوره ای استراحت کنید و به دستان خود استراحت دهید.
- با کیبورد، موس و ترک پد خود از یک تکیه گاه مچ دست استفاده کنید.
- “دست موش” خود را جایگزین کنید یا خود را آموزش دهید که از ماوس با دست غیر غالب خود استفاده کنید.
چه زمانی با دکتر تماس بگیرید
کی باید با دکتر تماس بگیرم؟
اگر تجربه کردید باید با ارائه دهنده مراقبت های بهداشتی خود تماس بگیرید:
- ناتوانی در حرکت دادن دست، مچ دست یا انگشتان.
- دردی که پس از دو هفته درمان خانگی ادامه دارد.
- گزگز دردناک بالا یا پایین بازو.
- قرمزی یا تورم غیرمعمول در ساعد، مچ دست، دست یا انگشتان.
بسیاری از افراد در برخی مواقع درد مچ دست را تجربه می کنند. خارج از رگ به رگ شدن یا شکستگی، سندرم تونل کارپال، تاندونیت و آرتریت از علل اصلی درد مچ دست هستند. ارائهدهنده مراقبتهای بهداشتی شما میتواند به شما کمک کند تا مشخص کند چه چیزی باعث درد مچ شما میشود و درمانهای مناسب را توصیه میکند. اغلب، درمانهای غیرجراحی مانند بستن آتل، اصلاح فعالیتها و انجام تمرینات دستی میتوانند علائم را کاهش دهند. اگر درد مچ دست در توانایی شما برای کار، خواب یا انجام فعالیت های روزانه اختلال ایجاد کند، ممکن است از جراحی سود ببرید.
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